title: Colonic mucormycosis presented with ischemic colitis in a liver transplant recipient.
abstract: Mucormycosis is an uncommon opportunistic fungal infection with high mortality in liver transplant recipients. Mucormycosis of the gastrointestinal tract can manifest with features similar to ischemic colitis. Typically signs and symptoms of non-gangrenous ischemic colitis resolve spontaneously within 24-48 h. On the other hand, the clinical course of the mucormycosis is commonly fulminant. We encountered a case of invasive fungal colitis presenting with abdominal pain and hematochezia in a liver transplant recipient. Endoscopic examination showed multiple shallow ulcerations and edema with mucosal friabilities on the sigmoid and distal descending colon, which was consistent with ischemic colitis. However, the histological examination obtained from endoscopic biopsies showed fungal hyphae with surrounding inflammatory cells and mucosal necrosis. The patient was successfully managed with antifungal agent without surgical treatment. Thus, early diagnosis and treatment is essential for improving the prognosis of invasive fungal infection after liver transplantation.
authors.affiliation: Department of Internal Medicine, University of Ulsan College of Medicine, Ulsan University Hospital, Dong-gu, Ulsan 682-813, South Korea.
authors.forename: Gi Won
authors.initials: GW
authors.lastname: Do
authors.forename: Seok Won
authors.initials: SW
authors.lastname: Jung
authors.forename: Jae-Bum
authors.initials: JB
authors.lastname: Jun
authors.forename: Jae Hee
authors.initials: JH
authors.lastname: Seo
authors.forename: Yang Won
authors.initials: YW
authors.lastname: Nah
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D001706:Biopsy; D017091:Colitis, Ischemic / Q000175:diagnosis / Q000209:etiology*; D003113:Colonoscopy; D042241:Early Diagnosis; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D009091:Mucormycosis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D009894:Opportunistic Infections / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D011237:Predictive Value of Tests; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000935:Antifungal Agents
keywords: Colon; Ischemia; Liver transplantation; Mucormycosis